2023 Form 5500 filing — Calais Community Hospital Tax Sheltered Annuity Plan
Plain-English filing summary
According to public Form 5500 filings published through the U.S. Department of Labor (DOL) Employee Benefits Security Administration (EBSA) via the EFAST2 system, this is the 2023 Form 5500 filing (EFAST2 acknowledgement 20240812092654NAL0005096531001) for Calais Community Hospital Tax Sheltered Annuity Plan, reported by Calais Community Hospital under EIN 86-2728785 and plan number 002. It reports 325 participants. Attached schedules in the loaded dataset include Schedule H (large plan financials), Schedule C (service provider compensation).
- EFAST2 acknowledgement
- 20240812092654NAL0005096531001
- Filing year
- 2023
- Form type
- 2
- Plan sponsor
- Calais Community Hospital
- EIN
- 86-2728785
- Plan number
- 002
- Location
- Calais, ME
- Participants
- 325
- Schedules available
- Schedule H, Schedule C
- Received date
- not reported in the loaded dataset
Reported financial snapshot (2023)
- Total assets (EOY)
- $12,271,162
- Total liabilities (EOY)
- $0
- Net assets (EOY)
- $12,271,162
- Employer contributions
- $0
- Participant contributions
- $278,462
- Total income / additions
- $1,578,641
- Benefits paid
- $807,675
- Administrative expenses
- $64,228
- Total expenses
- $871,903
- Net increase / (decrease)
- $706,738
- Schedule source
- Schedule H
Reported service provider compensation (Schedule C)
| Provider | Service | Direct comp. | Indirect comp. |
|---|---|---|---|
| Lincoln National Corp | SERVICE PROVIDER | $43,807 | $0 |
| Clearpoint Capital- Ameripris | CONSULTANT | $20,421 | $0 |